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How is the anterior drawer test performed in the ankle?
- Supine
- Tibia is pushed posterior while calcaneus is pulled anterior
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What is a positive for the anterior drawer test in the ankle? What does it indicate?
- Talus slides excessively anterior
- Anterior Talofibular ligament instability/tear
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What does a positive posterior drawer test in the ankle indicate?
Posterior talofibular ligament instability/tear
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What ligaments are torn by inversion? Eversion?
- Anterior and posterior talofibular - inversion
- Deltoid - Eversion
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How is Thompson's test performed?
- Prone
- Patients knee is bent to 90 degrees
- Squeeze calf muscle just below the widest point
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What is another name for Thompson's? What is a positive for Thompson's? What does it indicate?
- Simmond's
- No plantar flexion of foot
- Rupture of Achilles' tendon
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How is Medial stability test in the ankle performed?
- Supine
- Stabilize distal leg
- Pull calcaneus lateral
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What does a positive for the Medial stability test in the ankle indicate?
- Increased movement laterally
- Deltoid ligament instability
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What does a positive Lateral stability test in the ankle indicate?
Anterior talofibular ligament instability
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How is Morton's squeeze test performed?
- Supine
- Lateral compression of the metatarsal heads of the foot
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What is a positive for Morton's squeeze test? What does it indicate? How to treat?
- Increased pain between the metatarsal heads, most common between 3rd and 4th
- Morton's neuroma (tumor of a nerve)
- Adjust foot and instruct patient to wear wider shoes
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Ankle sprain grading
- Grade 1 - Decreased ROM, slight swelling
- Grade 2 - No ROM, increased swelling, bruising, partial tear of ligaments
- Grade 3 - complete tear, requires surgery
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How is Buerger's test performed?
- Supine
- Hold SLR at 45 degrees (rest on doctor's knee) for 3 minutes
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What is a positive for Buerger's test? What does it indicate?
- Foot will turn pale
- Buerger's disease
- Vascular compromise
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How is Homan's sign performed?
- Supine
- Doctor flexes the hip and knee to 90 degrees and squeezes the patient's calf
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What is a positive for Homan's sign? What does it indicate?
- Deep seated calf pain
- Deep vein thrombosis (DVT) (patient presents with red, swollen, hot, painful leg)
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What tests are done on the ankle and foot?
- Anterior drawer test
- Thompson's (simmond's) test
- Medial stability test
- Morton's squeeze test
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What tests are done for vascular exam of the leg?
- Buerger's test
- Homan's sign
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How is Bechterew's sitting test performed?
- Seated
- Patient actively extends one leg at a time
- Doctor resists hip flexion (raising knees)
- Patient attempts to extend both legs at the same time
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What is another name for Bechterew's? What is a positive for it? What does a positive indicate?
- Flip test, SLR in seated position
- Increased LBP or patient has to lean back
- Disc protrusion causing sciatic neuralgia
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How is Beery's tests performed?
- Seated
- Ask patient to sit down
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What is a positive for Beery's test? What does it indicate?
- Pain is relieved
- Tight hamstrings
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How is Belt test performed?
- Standing
- Patient flexes at waist to touch toes
- Doctor stabilizes patient's sacrum with their hips and patient bends forward again
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What is another name for the belt test? What is a positive for it? What does it indicate?
- Supported Adam's (first part is unsupported)
- Decreased pain with stabilization
- Sacroiliac lesion
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What does it indicate if pain persists in the belt test?
Lumbar lesion
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How is Bonnet's sign performed?
- Supine
- After SLR, lower just below point of pain, internally rotate and adduct the leg
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What is a positive for bonnet's? What does it indicate?
- Sciatic pain is reproduced
- Piriformis syndrome
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How is Bowstring sign performed?
- Supine
- After SLR, rest flexed knee on doctor's shoulder
- Apply pressure to the posterolateral thigh in the popliteal fossa
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What is a positive for Bowstring sign? What does it indicate?
- Sciatic pain
- Sciatica
- Lumbar nerve root compression
- Piriformis syndrome
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How is Bragard's sign performed?
- Supine
- After SLR, leg is lowered just below point of pain and foot is dorsiflexed
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What is a positive for Bragard's sign? What does it indicate?
- Increased pain with dorsiflexion on affected side only not opposite side
- Sciatic neuritis, spinal cord tumor, IVD lesion, nerve root irritation, SOL
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How is Sicard's test performed?
- Supine
- After SLR, patient's leg is lowered just below point of pain and toe is dorsiflexed
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What is a positive for Sicard's? What does it indicate?
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How is Turyn's test performed?
- Supine
- After SLR, patient's leg is on table and big toe is dorsiflexed
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What is a postive for Turyn's? What does it indicate?
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What tests are done for sciatica?
- Bechterew's
- Bowstring
- Bragard's
- Sicard's
- Turyn's
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